Breastfeeding Support From a Physiotherapist: How Physiotherapy Can Help With Engorgement, Blocked Ducts, Mastitis & Cracked Nipples
Breastfeeding is often described as natural, but that doesn’t mean it’s always easy. Many new parents experience challenges such as breast engorgement, blocked ducts, mastitis, and cracked nipples—especially in the first few weeks postpartum.
As a physiotherapist (and a mother who struggled in the early days of breastfeeding myself), I know how overwhelming these issues can feel. I also know how important timely, specialised support is. That’s why I’m excited to share that I hope to be offering dedicated breastfeeding physiotherapy services in the new year. If you need help urgently, please reach out—I'm happy to refer you to someone who can assist you straight away.
In the meantime, here is a helpful guide to the most common breastfeeding concerns and how physiotherapy can support your recovery and breastfeeding journey.
Breast Engorgement
Breast engorgement often occurs within the first week or two after delivery. As blood flow increases to support milk production—usually three to five days postpartum—the breasts may become overly full and swollen.
Signs & Symptoms of Engorgement
Engorged breasts may feel:
hard or tight
tender or warm to the touch
heavy or full
lumpy or swollen
Swelling can also extend toward the armpit, and the veins on the breast may appear more visible due to the stretched skin. Some women experience low-grade fever and fatigue, often called “milk fever.” You can continue breastfeeding with this fever, but it’s important to inform your GP to rule out infection.
If swelling or pain continues, consulting a lactation consultant or breastfeeding-support professional is recommended.
Blocked Milk Ducts
A blocked duct usually presents gradually and affects one breast. It occurs when milk flow is obstructed at the nipple or somewhere deeper within the ductal system.
Signs & Symptoms of a Blocked Duct
A hard lump or wedge-shaped area that feels tender, hot, swollen, or reddened
Pain that worsens before feeding and eases afterward
A lump that shifts position or feels smaller after nursing
Painful letdown
Occasional low fever
Thickened milk or “stringy” milk
Temporary drop in milk supply on the affected side
Mastitis
Mastitis is an inflammation of the breast that can be caused by obstruction, infection, or allergy. It is far more common in countries where breastfeeding is less frequent or routinely spaced. Many cases occur in the first 2–3 weeks postpartum.
Signs & Symptoms of Mastitis
Abrupt onset of pain
More intense swelling, heat, and discomfort than with a blocked duct
Red streaks extending from the affected area
Fever and flu-like symptoms (chills, aches, fatigue)
Lumpy, gelatin-like, or stringy milk (still safe for baby)
Occasionally blood, mucous, or pus in the milk
Baby may refuse the breast due to altered taste
Mastitis may be infectious or non-infectious, so antibiotics aren’t always required—but early assessment is key.
Cracked Nipples
Cracked nipples are typically due to nipple trauma and are especially common in the first month postpartum.
Common Causes
Poor latch or positioning
Tongue-tie
Incorrect breastfeeding technique
Pumping with the wrong flange size or excessive suction
Bottle-feeding before breastfeeding is established
Cracked nipples can lead to dryness, bleeding, and increased pain with latching.
How Physiotherapy Can Support Breastfeeding
Physiotherapy plays an important role in reducing pain, swelling, and inflammation, helping you continue breastfeeding comfortably and confidently.
1. Therapeutic Ultrasound for Engorgement, Blocked Ducts & Mastitis
Therapeutic ultrasound provides a gentle “micro-massage” that helps:
reduce inflammation
soften firm breast tissue
ease milk flow
support lymphatic drainage
It is:
pain-free
safe
compatible with your feeding routine
typically 20 minutes per session
often effective within 1–3 sessions
Supportive taping and hands-on techniques can further enhance relief. Physiotherapists can also provide guidance on feeding positions and refer to lactation consultants when needed.
2. Low-Level Laser Therapy for Cracked Nipples
Low-Level Laser Therapy (LLLT) is an effective, evidence-based treatment for:
healing nipple lesions
reducing pain
improving comfort during latch
supporting exclusive breastfeeding
The treatment is quick, comfortable, and does not interfere with feeding.
Looking Ahead: Breastfeeding Physiotherapy Services Coming in the New Year
Having personally experienced breastfeeding challenges, I deeply understand how vital early support is. I wished these options were available when I needed them, so I am committed to offering them to others.
I aim to launch full physiotherapy breastfeeding support services in the new year, including:
therapeutic ultrasound
low-level laser therapy
breast massage & lymphatic drainage
feeding-position guidance
breastfeeding-related pain management
referral network with lactation consultants across South Wales
If you require help urgently, please contact me, I'd be more than happy to guide you to someone who can assist right away.
